Department of Colorectal Surgery, King's College Hospital Foundation NHS Trust, London, UK.
Department of Radiology, King's College Hospital Foundation NHS Trust, London, UK.
Clin Radiol. 2021 Feb;76(2):117-121. doi: 10.1016/j.crad.2020.09.008. Epub 2020 Sep 21.
To review the indications for computed tomography colonography (CTC) performed on patients referred via the 2-week wait colorectal pathway (2WWCP).
A retrospective study was performed on all patients referred through the 2WWCP between October 2018 and September 2019. The referrals were audited against the National Institute for Health and Care Excellence (NICE) NG12/DG30 guidelines for referral to the 2WWCP, and against the Royal College of Radiologists (RCR) 2017 guidelines for CTC.
Over the study period, there were 1,707 2WWCP referrals, and 362 (21.2%) of these patients underwent CTC. The median age was 66 years, and 55% were female. Forty-six patients did not meet the NICE NG12/DG30 guidelines for referral to the 2WWCP, and a further 268, although meeting the NICE guidelines, did not meet the RCR 2017 guidelines for CTC. In total, only 13% of CTCs performed complied with both guidelines.
This audit demonstrated a significant opportunity to reallocate CTC resources in the recovery stage of the COVID-19 pandemic. To improve outcomes for colorectal cancer (CRC) in the UK, establishing a selective straight-to-test CTC 2WWCP should be considered. Documented consent detailing the risks and benefits of CTC versus colonoscopy should take place in order to assist the patient in making an informed choice.
回顾通过 2 周等待结直肠途径（2WWCP）转诊的患者进行计算机断层扫描结肠成像（CTC）的适应证。
对 2018 年 10 月至 2019 年 9 月期间通过 2WWCP 转诊的所有患者进行了回顾性研究。对转诊情况进行了审核，以符合国家卫生与保健卓越研究所（NICE）NG12/DG30 关于转诊至 2WWCP 的指南，以及符合皇家放射科医师学院（RCR）2017 年 CTC 指南。
在研究期间，有 1707 例 2WWCP 转诊，其中 362 例（21.2%）患者接受了 CTC。中位年龄为 66 岁，女性占 55%。46 例不符合 NICE NG12/DG30 关于转诊至 2WWCP 的指南，另有 268 例尽管符合 NICE 指南，但不符合 RCR 2017 年 CTC 指南。总共只有 13%的 CTC 符合这两项指南。
该审计表明，在 COVID-19 大流行恢复期重新分配 CTC 资源的机会很大。为了提高英国结直肠癌（CRC）的治疗效果，应考虑建立一个选择性的直接进行 CTC 2WWCP 的方案。应记录详细说明 CTC 与结肠镜检查的风险和益处的知情同意书，以帮助患者做出明智的选择。
